According to Dale J. Block, MD, “Healthcare stewardship and environmental stewardship are inseparable. Environmental degradation has a direct impact on the health of our population, which in turn places demands on our healthcare resources. Ecological medicine makes the important connection between caring for the environment and caring for our health.”

The following article is excerpted from Dr. Block’s recent book, Healthcare Stewardship: A Guide to Improving the Health of All Americans.

The growing disillusion with mainstream or conventional medical care has lead to a widespread public search for alternatives. The U.S. health care system’s deep dependence on synthetic chemicals, the long-standing refusal by all stakeholders to acknowledge how profoundly these agents have disrupted our ecological systems due to their irresponsible use—coupled with the increasing costs of health care—are leading many Americans to question the basics of how to become healthy and well.

Ecological medicine has as its central theme a belief that in the industrialization of civilization, we made a strategic error in acting as if humans were apart from nature. Ecological medicine, as a developing medical specialty, could well emerge as a major force of cultural change. In fact, ecological medicine could be the missing link for establishing a health care stewardship movement focusing on the responsible use of our limited health care resources.

Ecological medicine proposes to reshape how industrial civilization operates, in part by redefining the role that all stakeholders of the U.S. health care delivery system must play in making the decisions that affect all life on Earth. Improving human health links to restoring ecological well-being. The interconnectedness of all life is a “fundamental biological truth,” states Kenny Ausubel in his book Ecological Medicine: Healing the Earth, Healing Ourselves.

The basic tenants of ecological medicine include the following:

• The first goal of medicine is to establish the conditions for health and wholeness, thus preventing disease and illness.

• The second goal of medicine is to cure.

• The earth is also the clinician’s client: Therefore, the patient under the clinician’s care is one part of the earth.

• Humans are part of a local ecosystem.

• Disturbing an ecosystem can affect the health and well-being of humans.

• Medicine, in general, should not add to the illnesses of humans or the earth.

• Medical care should not damage other species on the earth or the ecosystem.

The “precautionary principle” is the primary mechanism for implementing the basic tenets of ecological medicine. This principle argues that science and industry must fully assess the impact of their activities (i.e., environmental health risk assessment) before they impose them upon the public and the environment.

Prior to the precautionary principle rising to the center of the recent debate on health and well-being related to the environment, the scientific and medical community operated on the principle that a certain amount of pollution and disease is the price that society must pay to live a modern life. This is the “risk paradigm” and it places the burden of proof that new technologies and industrial processes may be harmful to society.

The risk paradigm assumes that there are acceptable levels of contamination that the earth and local ecosystems (including humans) can assimilate. Large commercial interests drive the science behind the risk paradigm. In reality, the ability of science, in general, to predict consequences and possible harm to all living things is limited.

The precautionary principle recognizes that all life is interconnected. This principle essentially shifts the burden of proof and liability to the parties promoting potentially harmful technologies. It also limits the use of those technologies to experimentation under controlled and safe environments until they prove to be truly safe to living things.

In essence, the precautionary principle serves as an insurance policy against our own (i.e., human) arrogance and ignorance. Predicting the complexity of living systems is extraordinarily difficult at best. Therefore, complex scientific decisions need to be guided by the precautionary principle and not the risk paradigm.
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Dale J. Block, MD, CPE, has been a licensed, practicing physician for 21 years. Board certified in Family Practice and Medical Management, | Living Green Magazine |

Monday February 4, 2013, 6:29 pm
Wow, great article, thanks Kit. Another person (Dr.) who finally 'Get's it"! Also another person who should be heard, listened, and taken to their personal mind and actions around the world, but probably won't be. I'm cynical also, like Pam W., but hope the Good Words are spread as Dave C. asks.